Incidence of Future Shoulder Procedures after SLAP Repair

Introduction: Previous literature has shown a high revision rate after a SLAP repair operation, which led to a decreased number of SLAP repairs being performed and an increased emphasis on patient selection. The transition to the ICD-10 coding system has allowed for more descriptive coding, enhancing the validity of the data mined from large databases. This study aims to assess the surgical revision rate, risk factors for revision, and subsequent procedures after a superior labrum anterior and posterior (SLAP) repair surgery. Materials & methods: Data for the study were obtained from the national private insurance database Pearl Diver (years 2007 - 2020). All included patients underwent their first SLAP repair surgery with at least two years of follow-up. Patients were queried using Current Procedural Terminology (CPT) code 29807 and concurrent ICD-10 shoulder pathology diagnosis codes. The database was used to determine the revision rate of Subsequent Shoulder Procedures (SSP). The time between index surgery and subsequent procedures was noted. Finally, a logistic regression analysis with a significance cut-off of p ≤ 0.05 was conducted to determine the risk factors for a subsequent procedure after a SLAP repair. Results: Out of 91 million patients, 15,958 patients (16,611 shoulders) met the criteria for the study. 1,389 (8.36%) repaired shoulders underwent a subsequent shoulder procedure on average 1.13 years after their initial SLAP repair. Younger age (OR = 1.01), elevated CCI (OR = 1.07), female gender (OR = 1.3), tobacco use (OR = 1.37), and obesity (OR = 1.21) significantly increased the risk of a subsequent shoulder procedure. Subacromial decompression, debridement, rotator cuff repair, manipulation under anesthesia, and revision SLAP repair were the most common subsequent procedures. Discussion: An additional procedure may be necessary for approximately 1 in 12 patients a year after SLAP repair surgery. Patients who are younger, female, obese, have an increased CCI, and use tobacco are at increased risk of undergoing a revision procedure. Overall, the rate of revision procedures patients experience after a SLAP repair is less than initially reported.